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Barrera-Valencia C, Perea-Flórez EX. Comparison of Costs in Teledermatology Using PC and Camera Versus Smartphone. Telemed J E Health 2024. [PMID: 38669106 DOI: 10.1089/tmj.2023.0369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Introduction: One of the challenges faced by the Colombian Health System is to improve access to health services for the dispersed and isolated rural population, particularly in the field of dermatology. This article examines the implementation of a teledermatology service using a PC and camera versus smartphone technology. Methods: A total of 542 teledermatology visits were conducted, involving 478 patients, in addition to 64 visits for clinical follow-up for patients as per the dermatologist's recommendation. Out of the 478 patients, 461 met the inclusion criteria and agreed to participate in the study. The data collection instrument from the general practitioner or referring provider covered three consultation moments: (1) sending an initial consultation, (2) providing a response to the patient, and (3) sending a follow-up consultation. Seven hundred forty-seven records were completed by the general practitioner for the three consultation moments. Furthermore, 372 consultations were documented by the dermatologist or referring provider for two moments: (1) response to the initial consultation by the dermatologist, and (2) response to the follow-up consultation by the dermatologist. After validating the information reported in the instruments, a descriptive analysis of the data was conducted, utilizing absolute frequencies and percentages for qualitative variables and measures of central tendency (mean, median, standard deviation, and interquartile range) for quantitative variables. The data were analyzed from 747 records of the referring provider instrument related to 461 patients, between 18 and 98 years of age, with a predominantly female representation. Results: The results indicated that for teleconsultations conducted using a mobile device, the average total duration of the teleconsultation was longer on the traditional platform compared with the mobile device (13.03 vs. 8.27 min). Additionally, it was observed that the time taken to store, send, and capture a single image (clinical or dermoscopic) using the mobile device was three times lower than that on the conventional platform (25 vs. 75 s). Similar findings were noted for teleconsultations carried out by the dermatologist, predominantly utilizing a mobile device. The average consultation time was shorter for the mobile device compared with the traditional platform (8.14 vs. 12 min). Conclusions: The cost reduction suggests that the operation of the service is more efficient with smartphone technology in comparison to the use of a PC and camera. Teledermatology with smartphones provides a streamlined, efficient, and technically sound process for obtaining clinical and dermoscopic images.
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Affiliation(s)
- Camilo Barrera-Valencia
- Oficina Docencia e Investigación, Hospital Universitario Centro Dermatológico Federico Lleras Acosta, Bogotá, Colombia
| | - Elin Xiomara Perea-Flórez
- Oficina Docencia e Investigación, Hospital Universitario Centro Dermatológico Federico Lleras Acosta, Bogotá, Colombia
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2
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Bourkas AN, Barone N, Bourkas MEC, Mannarino M, Fraser RDJ, Lorincz A, Wang SC, Ramirez-GarciaLuna JL. Diagnostic reliability in teledermatology: a systematic review and a meta-analysis. BMJ Open 2023; 13:e068207. [PMID: 37567745 PMCID: PMC10423833 DOI: 10.1136/bmjopen-2022-068207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES To compare teledermatology and face-to-face (F2F) agreement in primary diagnoses of dermatological conditions. DESIGN Systematic review and meta-analysis METHODS: MEDLINE, Embase, Cochrane Library (Wiley), CINAHL and medRxiv were searched between January 2010 and May 2022. Observational studies and randomised clinical trials that reported percentage agreement or kappa concordance for primary diagnoses between teledermatology and F2F physicians were included. Titles, abstracts and full-text articles were screened in duplicate. From 7173 citations, 44 articles were included. A random-effects meta-analysis was conducted to estimate pooled estimates. Primary outcome measures were mean percentage and kappa concordance for assessing diagnostic matches between teledermatology and F2F physicians. Secondary outcome measures included the agreement between teledermatologists, F2F dermatologists, and teledermatology and histopathology results. RESULTS 44 studies were extracted and reviewed. The pooled agreement rate was 68.9%, and kappa concordance was 0.67. When dermatologists conducted F2F and teledermatology consults, the overall diagnostic agreement was significantly higher at 71% compared with 44% for non-specialists. Kappa concordance was 0.69 for teledermatologist versus specialist and 0.52 for non-specialists. Higher diagnostic agreements were also noted with image acquisition training and digital photography. The agreement rate was 76.4% between teledermatologists, 82.4% between F2F physicians and 55.7% between teledermatology and histopathology. CONCLUSIONS AND RELEVANCE Teledermatology can be an attractive option particularly in resource-poor settings. Future efforts should be placed on incorporating image acquisition training and access to high-quality imaging technologies. TRIAL REGISTRATION NUMBER 10.17605/OSF.IO/FJDVG.
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Affiliation(s)
| | - Natasha Barone
- Faculty of Medicine and Health Sciences, McGill University Montreal, Montreal, Quebec, Canada
| | | | | | - Robert D J Fraser
- Nursing, Western University Arthur Labatt Family School of Nursing, London, Ontario, Canada
- Swift Medical, Toronto, Ontario, Canada
| | - Amy Lorincz
- Independent Researcher, Montreal, Qubec, Canada
| | - Sheila C Wang
- Swift Medical, Toronto, Ontario, Canada
- Dermatology, McGill University Department of Medicine, Montreal, Qubec, Canada
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3
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Mocharnuk J, Lockard T, Georgesen C, English JC. Inpatient Teledermatology: a Review. CURRENT DERMATOLOGY REPORTS 2022; 11:52-59. [PMID: 35402084 PMCID: PMC8976271 DOI: 10.1007/s13671-022-00360-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 11/22/2022]
Abstract
Purpose of Review Inpatient teledermatology is a rapidly growing field with significant potential to add value and streamline patient care. This review summarizes the current literature on inpatient teledermatology, primarily focusing on its diagnostic and clinical management utility as compared to live dermatologic evaluation. Recent Findings The COVID-19 pandemic has accelerated the adoption of inpatient teledermatology, which has been shown to be comparable to live hospitalist evaluation for triage, diagnosis, and management of hospitalized patients for a wide variety of conditions. Despite its comparative cost-effectiveness and recent changes in reimbursement practices, inpatient teledermatology still lacks sufficient reimbursement incentive for widespread implementation. Summary Inpatient teledermatology is an effective, efficient, accurate, and cost-effective means of managing the hospital burden of skin disease, especially in areas where access to dermatologic care is limited. It is essential that dermatologists and referring providers comprehend the use and potential pitfalls of inpatient teledermatology to effectively incorporate it into hospital practice.
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4
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Payvandi L, Parsons C, Bourgeois FC, Hron JD. Inpatient telehealth experience of limited English proficient patients: a cross-sectional survey and semi-structured interview (Preprint). JMIR Form Res 2021; 6:e34354. [PMID: 35438641 PMCID: PMC9066319 DOI: 10.2196/34354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/17/2022] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
Background Patients with limited English proficiency (LEP) are at a higher risk of poor health outcomes and are less likely to use telehealth than English-speaking patients. To date, there is no formal evaluation of inpatient (IP) telehealth user experience of patients and their families by language preference during visits with their clinicians. Objective This study aims to compare the experiences of English- and Spanish-speaking patients and their families using IP telehealth, as well as to evaluate the experience of Spanish interpreters providing services through IP telehealth. Methods We prospectively administered a survey to English- and Spanish-speaking patients and their families who used IP telehealth from October 1, 2020, to March 31, 2021. We performed semistructured phone interviews of hospital-based Spanish interpreters who provided services through IP telehealth. Results A total of 661 surveys were administered, with completion rates of 18% (112/621) in English and 62% (25/40) in Spanish. On a 10-point scale, the overall satisfaction of Spanish speakers (median 10, IQR 10-10) was higher than that of English speakers (median 9, IQR 8-10; P=.001). Both English- and Spanish-speaking patients used IP telehealth for visits with their primary IP care team, subspecialty consultants, and other clinicians. Hospital tablets were used more often than personal devices, and only English-speaking patients used personal laptops. Patients and their families encountered challenges with log-in, team coordination with multiple users, and equipment availability. Interpreters encountered challenges with audio and video quality, communication, safety, and Wi-Fi access. Conclusions Both English- and Spanish-speaking patients reported high satisfaction using IP telehealth across multiple disciplines despite the workflow challenges identified by interpreters. Significant investment is needed to provide robust infrastructure to support use by all patients, especially the integration of multiple users to provide interpreter services for patients with LEP.
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Affiliation(s)
- Lily Payvandi
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
| | - Chase Parsons
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Fabienne C Bourgeois
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Jonathan D Hron
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
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5
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Tognetti L, Cartocci A, Balistreri A, Cataldo G, Cinotti E, Moscarella E, Farnetani F, Lallas A, Tiodorovic D, Carrera C, Longo C, Puig S, Perrot JL, Argenziano G, Pellacani G, Rubegni P, Cevenini G. The Comparative Use of Multiple Electronic Devices in the Teledermoscopic Diagnosis of Early Melanoma. Telemed J E Health 2021; 27:495-502. [DOI: 10.1089/tmj.2020.0057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Alessandra Cartocci
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Alberto Balistreri
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Gennaro Cataldo
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Aimilios Lallas
- First Department of Dermatology, Aristotele University, Thessaloniki, Greece
| | | | - Cristina Carrera
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - Caterina Longo
- High Diagnostic Technology Oncology Center - IRCCS, Reggio Emilia, Italy
| | - Susanna Puig
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - Jean Luc Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | | | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Gabriele Cevenini
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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6
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Tognetti L, Fiorani D, Russo F, Lazzeri L, Trovato E, Flori ML, Moscarella E, Cinotti E, Rubegni P. Teledermatology in 2020: past, present and future perspectives. Ital J Dermatol Venerol 2021; 156:198-212. [PMID: 33960751 DOI: 10.23736/s2784-8671.21.06731-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Born in 1995, teledermatology (TD) turns 25 years old today. Since then, TD evolved according to patients and physicians needs. The present review aimed to summarize all the efforts and experiences carried out in the field of TD and its subspecialties, the evolution and the future perspectives. A literature search was conducted in PubMed and Google Scholar. The state of the art of the "tele-dermo research" included TD and clinical trials, TD/TDS web platforms, TDS and artificial intelligence studies. Finally, the future perspective of TD/TDS in the era of social distancing was discussed. Using TD in specific situations adds several benefits including time-effectiveness of intervention and reduction in the waiting time for the first visit, reduced travel-costs, reduced sanitary costs, equalization of access from patient to specialistic consult. The communication technologies devices currently available can adequately support the growing needs of tele-assistance. A main limit is the current lack of a common clear European regulation for practicing TD, encompassing privacy issues and data management. The pandemic lockdown of 2020 has highlighted the importance of performing TD for all those patient, elderly and/or fragile, where the alternative would be no care at all. Many efforts are needed to develop efficient workflows and TD programs to facilitate the interplay among the different TD actors, along with practice guidelines or position statements.
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Affiliation(s)
- Linda Tognetti
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy -
| | - Diletta Fiorani
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Filomena Russo
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Laura Lazzeri
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Emanuele Trovato
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Maria L Flori
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Elvira Moscarella
- Unit of Dermatology, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Elisa Cinotti
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
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7
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Hron JD, Parsons CR, Williams LA, Harper MB, Bourgeois FC. Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic. Appl Clin Inform 2020; 11:452-459. [PMID: 32610350 DOI: 10.1055/s-0040-1713635] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Relaxation of laws and regulations around privacy and billing during the COVID-19 pandemic provide expanded opportunities to use telehealth to provide patient care at a distance. Many health systems have transitioned to providing outpatient care via telehealth; however, there is an opportunity to utilize telehealth for inpatients to promote physical distancing. OBJECTIVE This article evaluates the use of a rapidly implemented, secure inpatient telehealth program. METHODS We assembled a multidisciplinary team to rapidly design, implement, and iteratively improve an inpatient telehealth quality improvement initiative using an existing videoconferencing system at our academic medical center. We assigned each hospital bed space a unique meeting link and updated the meeting password for each new patient. Patients and families were encouraged to use their own mobile devices to join meetings when possible. RESULTS Within 7 weeks of go-live, we hosted 1,820 inpatient telehealth sessions (13.3 sessions per 100 bedded days). We logged 104,647 minutes of inpatient telehealth time with a median session duration of 22 minutes (range 1-1,961). There were 5,288 participant devices used with a mean of 3 devices per telehealth session (range 2-22). Clinicians found they were able to build rapport and perform a reasonable physical exam. CONCLUSION We successfully implemented and scaled a secure inpatient telehealth program using an existing videoconferencing system in less than 1 week. Our implementation provided an intuitive naming convention for providers and capitalized on the broad availability of smartphones and tablets. Initial comments from clinicians suggest the system was useful; however, further work is needed to streamline initial setup for patients and families as well as care coordination to support clinician communication and workflows. Numerous use cases identified suggest a role for inpatient telehealth will remain after the COVID-19 crisis underscoring the importance of lasting regulatory reform.
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Affiliation(s)
- Jonathan D Hron
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States
| | - Chase R Parsons
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States
| | - Lee Ann Williams
- Patient Care Operations, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Marvin B Harper
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States.,Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Fabienne C Bourgeois
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States
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8
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Cao B, Zhao P, Bien-Gund C, Tang W, Ong JJ, Fitzpatrick T, Tucker JD, Luo Z. The Web-Based Physician is Ready to See You: A Nationwide Cross-Sectional Survey of Physicians Using a Mobile Medical App to Evaluate Patients With Sexually Transmitted Diseases in China. JMIR Mhealth Uhealth 2018; 6:e10531. [PMID: 30377148 PMCID: PMC6234337 DOI: 10.2196/10531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/17/2018] [Accepted: 08/27/2018] [Indexed: 01/13/2023] Open
Abstract
Background Web-based medical service provision is increasingly becoming common. However, it remains unclear how physicians are responding to this trend and how Web-based and offline medical services are linked. Objective The objectives of this study were to examine physicians’ use of mobile medical apps for sexually transmitted disease (STD) consultations and identify the physicians who frequently use mobile medical apps to evaluate patients with STD. Methods In August 2017, we conducted a nationwide cross-sectional survey among physicians registered on a mobile medical app in China. We collected data on physicians’ demographic information, institutional information, and Web-based medical practices. We compared physicians who used mobile medical apps to evaluate patients with STD frequently (at least once a week) with infrequent users. Bivariate and multivariate logistic regressions were used to identify physicians who frequently evaluated patients with STD on mobile medical apps. Results A total of 501 physicians participated in the survey. Among them, three-quarters were men and the average age was 37.6 (SD 8.2) years. Nearly all physicians (492/501, 98.2%) recommended their last Web-based patient with STD to subsequently see a physician in the clinic. More than half (275/501, 54.9%) of physicians recommended STD testing to Web-based patients, and 43.9% (220/501) provided treatment advice to patients with STD. Of all physicians, 21.6% (108/501) used mobile medical apps to evaluate patients with STD through Web more than once a week. Overall, 85.2% (427/501) physicians conducted follow-up consultation for patients with STD using mobile medical apps. Physicians working at institutions with STD prevention materials were associated with frequent evaluation of patients with STD on mobile medical apps (adjusted odds ratio=2.10, 95% CI 1.18-3.74). Conclusions Physicians use mobile medical apps to provide a range of services, including Web-based pre- and posttreatment consultations and linkage to offline clinical services. The high rates of referral to clinics suggest that mobile medical apps are used to promote clinic-seeking, and not replace it. Physicians’ use of mobile medical apps could benefit sexual minorities and others who avoid formal clinic-based services.
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Affiliation(s)
- Bolin Cao
- Shenzhen University, Shenzhen, China.,University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China
| | - Peipei Zhao
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Cedric Bien-Gund
- University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China
| | - Weiming Tang
- University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China.,University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jason J Ong
- Social Entrepreneurship to Spur Health, Guangzhou, China.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas Fitzpatrick
- Social Entrepreneurship to Spur Health, Guangzhou, China.,University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Joseph D Tucker
- University of North Carolina Project - China, Guangzhou, China.,Social Entrepreneurship to Spur Health, Guangzhou, China.,University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zhenzhou Luo
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
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9
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Clark AK, Bosanac S, Ho B, Sivamani RK. Systematic review of mobile phone-based teledermatology. Arch Dermatol Res 2018; 310:675-689. [DOI: 10.1007/s00403-018-1862-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 05/30/2017] [Accepted: 08/27/2018] [Indexed: 12/17/2022]
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10
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Lee KJ, Finnane A, Soyer HP. Recent trends in teledermatology and teledermoscopy. Dermatol Pract Concept 2018; 8:214-223. [PMID: 30116667 PMCID: PMC6092076 DOI: 10.5826/dpc.0803a13] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/21/2018] [Indexed: 11/28/2022] Open
Abstract
Teledermatology is a useful alternative where specialized dermatological assistance is not available and has been used successfully to support health professionals in a wide range of settings worldwide, in either an asynchronous store-and-forward format or a real-time video conferencing format. Teledermoscopy, which includes dermoscopic images in the teleconsultation, is another addition that improves remote assessments of pigmented lesions. A more recent variant is mobile teledermoscopy, which uses a smartphone to deliver the same type of service. Teledermoscopy’s greatest strength may be as a triage and monitoring tool, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. While face-to-face (FTF) care remains the gold standard for diagnosis, drawbacks of not using FTF care as the primary method can be mitigated if teleconsultants are willing to refer to FTF care whenever there is uncertainty. Teledermatology has generally been well accepted by patients and practitioners alike. Barriers to the large-scale use of teledermatology remain. Assigning medicolegal responsibility and instituting a reimbursement system are critical to promoting widespread use by medical professionals, while privacy and security features and a mechanism to link teleconsultations to patients’ existing health records are essential to maximize patient benefit. Direct-to-consumer services also need attention from regulators to ensure that consumers can enjoy the benefits of telemedicine without the dangers of unregulated or untested platforms.
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Affiliation(s)
- Katie J Lee
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Anna Finnane
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia.,The University of Queensland, School of Public Health, Herston, Australia
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia.,Department of Dermatology, Princess Alexandra Hospital, Brisbane, Australia
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11
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Fiks AG, Fleisher L, Berrigan L, Sykes E, Mayne SL, Gruver R, Halkyard K, Jew OS, FitzGerald P, Winston F, McMahon P. Usability, Acceptability, and Impact of a Pediatric Teledermatology Mobile Health Application. Telemed J E Health 2018; 24:236-245. [DOI: 10.1089/tmj.2017.0075] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Alexander G. Fiks
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Linda Fleisher
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Lindsay Berrigan
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Emily Sykes
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stephanie L. Mayne
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rachel Gruver
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Katherine Halkyard
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Olivia S. Jew
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Patrick FitzGerald
- Office of Entrepreneurship and Innovation, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Flaura Winston
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Office of Entrepreneurship and Innovation, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Patrick McMahon
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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12
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A Systematic Review of the Use of Telemedicine in Plastic and Reconstructive Surgery and Dermatology. Ann Plast Surg 2017; 78:736-768. [DOI: 10.1097/sap.0000000000001044] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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13
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Wang Y, Zhao Y, Zheng J, Zhang A, Dong H. The evolution of publication hotspots in the field of telemedicine from 1962 to 2015 and differences among six countries. J Telemed Telecare 2017; 24:238-253. [PMID: 28347217 DOI: 10.1177/1357633x17693749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Telemedicine has been implemented in many countries and has captured the attention of many researchers. Herein, we aim to quantify publication hotspots in the field of telemedicine, analyse their evolution, compare them in different countries, and provide visual representations. Methods We used software tools to process PubMed entries for a 54-year period and identified publication hotspots using keyword frequency analysis. We employed a keyword co-occurrence analysis, principal component analysis, multidimensional scaling analysis, and network visualization technology. Results The number of Medical Subject Heading (MeSH) terms increased with time. The most common subcategories of telemedicine between 1962 and 2015 were Remote Consultation, Teleradiology, and Telepathology. The most popular information communication technologies in telemedicine publications were related to the Internet and cell phones. The topics of Patient Satisfaction, Treatment Outcomes, and Home Care Services associated with telemedicine were highlighted after the 1990s. Use frequency of the terms Cell Phones and Self-Care increased drastically in the past six years, and the publication focus in six countries that had the highest output was different. Knowledge network maps and perceptual maps show the relationship between high-frequency MeSH terms. Discussion The telemedicine field has experienced significant growth and expansion in knowledge and innovation in the last 54 years. Publication hotspots for telemedicine lean towards clinical treatment, home care services, and personal care, and countries emphasize publishing in areas related to their national characteristics. This study quantitatively discusses publication hotspots, provides an objective and systematic understanding of this field, and suggests directions for future telemedicine research.
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Affiliation(s)
- Yanjun Wang
- 1 School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Ye Zhao
- 1 School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jianzhong Zheng
- 1 School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Ailian Zhang
- 1 School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Haiyuan Dong
- 2 Shanxi Health Education Center, Taiyuan, China
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